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22519 95TH PL W.PDFiiiiiiiiiiii 9359 22519 95TH PL W GARY HAAKENSON CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221 MAYOR DEVELOPMENT SERVICES DEPARTMENT Planning - Building - Engineering tic. i S9 March 29, 2002 Craig & Lynne Murdock 22519 95"' Place West Edmonds, WA 98020 Subject: Determination regarding Critical Areas Checklist: CA-02-59 Dear Applicant: Enclosed please find a copy of the Critical Areas Checklist you submitted. The 'DETERMINATION" reached by the City is located on the reverse side of the form (bottom of page). IT IS VERY IMPORTANT FOR YOU TO RETAIN A COPY OF TIHS CRITICAL AREAS "DETERMINATION" FOR YOUR RECORDS. Please examine this Determination for additional requirements. You may need to submit additional information such as an Environmental Checklist or Critical Areas Study: The Determination for the Critical Areas Checklist you submitted is a site -specific determination, not a project -specific determination. YOU MUST SUBMIT A COPY OF THE CRITICAL AREAS CHECKLIST and DETERMINATION WITH ALL PERMIT APLICATIONS OR YOUR APPLICATION WILL NOT BE PROCESSED. Permit applications include the following: Building Permits Conditional Use Permits Subdivisions Variances Applications to the ADB* Land Use Applications Any other development permit applications. Thank you, Planning Secretary *Architectural Design Board D:mydocuments/spellman/CACL]etter.doc L:temp/jana/CACLIetter.doc Incorporated August 11, 1890 Sister City - Hekinan, Japan MAR-20-20M 09:05 CITY OF EDMONDS 425??10221 P.02/05 V. City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 The Critical Areas Checklist contained on this form is to be filled out by, any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of the application to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are, or may be, present on the subject property. The information needed to complete the Checklist should be easily w,,ailable from observations of the she or data available at City Hall (Critical areas inventories, maps, or soil surveys). Date Received: <.-3--25 —0 c-;)L- City Recelpt #: Z t2 3 '7 Critical Areas File Critical Areas Checkilst Fee: $g.00 Date Mailed to Applicaft A property owner, or his/her authorized representative, must fill out the checklis� sign and date it, and submit it to the City. The City will review the checklist� make a precursory site visit, and make a determination of the subsequent smps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this fonn to assist City staff in finding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent information (e.g. site plan, topogmphy map, etc.) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. 'ne undersigned applicant, and his/herfits heirs, and assips, in consideration on the processing of the application agms to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action or infmction based in whole or part upon false, misleading, inaccurate or incomplete information fumished by the applicant, his/her/its agents or employees. By my signature, I certify that the infonnation and exhibits knowledge and that I am authorized to file pdis�pplication P� siGNATTm OF APPLicAN(VAGENT Property Owner's Authorization I By my signature, I certify that I have al/rizec and grant my permission for the public officials purposes of inspection and p i �P�tendant to r, 7 SIGNATM OF OWNER -ewith submitted are true and conW to the beg of my behalf of the owner as " 7�, DATE the above ApplicantlAgent to apply for the subject land use application, ind the staff of the City of Edmonds to enter the subject property for the Owner/Applicant: of, & '�,VA-e XU9C10Ck Name �J d/ Street Address city State Zip Telephod. Email address (optional): DATE, 3 — All Applicant Representativ A 5� J Name Street Address / a bull— Citv State Zip Telephone(42s) '743— Email Address (optional): CritiW Areas Checklistdod3.19.2001 4. - nl24'- V122— V'" 124-- 122117-122116- 1 M50 w 117 LLJ 22120 Imm=1 L a" r r IV sm - I 1 1. 114 22401 22" n,607 Mae % —224TH T SW — \ 2707 4"d V"' 21414 V_ 9 a 224tt 2211. — VIda 021. w", n413 2242 — — F 22422 22421 22422 22425 n421 R 22413 22412 22413 22"a 22112 1; V"a "422 n423 22120 1 2427 2242g — 13 22410 22417 22423 F _ 224M 22405 22428 V512 22422 1 VQ0 22429 P. r-- 22421 .4 M2 0)�2 22421 22420 22125 =to k I. 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POST FRAME BUILDINGS AdmInistrative Headquarters: (425)743-1655 11110111V FAX: (425) 742-4378 Toll Free: 1-800-824-9562 :;�xistlng buildings TOWNCPF099LT building 0 Setbacks of proposed & existing buildings oli�rli)lain road with name 0 Bodies of water 0 Floorplan Cont. or's Uc. M 0 Easements Qudj&j Ow Fwww Depends On It. OAccess to proposed building 0 Slopes & Contours (Tincrements) 0, Jo b Name* Job Site Address: as.� Legal Pe cription-.... TaxAccount,0' Lo + PA ellx�. j 00, eel Ck.-ttkm 0 1" r'j A— I Cot 00, Poo, �j DO NOT SIGN INCOMPLETE SITE PLANI Customer has verified and approved the location of the building, orientation of the building to the North, and verifies that all White - Customer Copy White - Office Copy Yellow - Accounting Pink - Production utilities are shown on this drawing in the correct location. * ------------------------------ : MetroScan / Snohomish Owner :Zener Lynne E CoOwner Site Addr :22519 95Th Pl W Edmonds 98020 Mail Addr :22519 9STh Pl W Edmonds Wa 98020 Rec Date :06/23/1993 Deed :Warranty Price :$135,000 Full Loan :Conventional Aud Fee# :182 LnAmt :$90,000 ActualUse : Lender :Crossland Mortg Vest Type :Unmarried Person IntTyp:Fixed Bldg Name : Land Use :111 Res,Single Family Res,Detached NbrhdCode :3105000 Zoning :Rs-8000 Sub/Plat :Pine Crest Legal :PINE CREST BLK 000 D-00 - TR 71 : - - - - - - - - - - - - - - - - - - - - - - - - - RTSQ :03E27N25 -SE APN :00 5443 000 071 00 OldParcel :5443 000 071 00 08 Parcel ID :1130891 Structure :$70,700 Land :$87,000 Total :$157,700 Levy Cd :00216 2001 Tax :$2,012.28 Phone :425-672-1318 %Owned :100 Volume :13 Page :55 Easmnt Census Tract :508.00Block :4 Map Grid :474 H1 Bedrooms 2 Bldg SF :1,214 LotAcre Year Blt :1956 Bath F/H 2 1st SF :1,214 Lot SF EffYrBlt :1965 Stories :1 2nd SF Roof BldgGrad :Avg Fireplace :1 3rd SF View BldgCond :Good Units :1 4th SF WtrFront Water :Yes LowerLvlSF : BsmntSF Sewer :Sewer Information compiledfrom various sources. Real Estate Solutions makes no representations or warranties as to the accuracy or completeness of information contained in this report.. =METROSCAN PROPERTY PROFILE= Snohomish (WA) Parcel Number Becirooms 2 Bath Full 2 Both 112 Both Total 2.00 Flooring Crpt\Vinyl Fireplace I Central.4 ir Garage Attached Units I Stories I GurageSqFt 294 Total Bldgs I B/a�g SF 1,214 BsIni Type Patio SqFt 817 Porch&IFI 168 UTILITIES ElectService Yes Water Yes Sewer Type Sewer Gas OTHER INFORiVI.-I TION Elevator FireSprinklers Street Sulfiwe Paved Street Acces.s Yes Sitleiralk Grouncl Cover Cleared Right to Form Right to Forest 00 5443 000 071 00 PROPERTY CHARACTERISTICS Ist Floor SqFt 1.214 LofAcres 2nd Floor SqFt Lot SqFt 3ra' Floor SqFt year Built 1956 4th Floor ScIFf EJ)'YearBlt 1965 A boveGrnd SqFt 1,214 Blclg Tvpe Bsnint Fin SqFt Rooj'Type Composition BSInnt UnFin SF RooJ'Shape Pitched Bsnint Total SF sicling Brick\Wood Loft SqFt FoUnClatiOn Concrete Deck SqFi Blog Gracle Av.- Lower Level SF Bla�l� Con(/ Good Low Lvl Fin SF Construclion Wood Frame W/Sheathim! BsInt Founcl Full Crawl Heat Tvpe Forced Flot Air-Elec Oil/ Bililtlin.1zs 1-4 1. General Purpose Bld- X Other 2. Concp 3. Cnpy/ 4. fVowifi-oni Tvpe 11"ofelfi-ont 0/1.1. Lowlancls Topograph.1, I TopographY 2 Topograpl�v 3 Topograph.1- Prb View ollolio; Projile-Page 2 (?1'2 117fiffillilli011 LOMI)i1edft0111 1-Urious %um,,.% Real 1.�IwLfSolwhm,� imikes no;eprestmtations 0/ J I (Irr, III/ilf.S I J.N fo 1/11! I1(*C'11;1JL.1 or Lvmpleten,:�� )fi))firmwion contubied m this report. MAR-20-2002 09:05 CITY OF EDMONDS 425??10221 P.02/05 City of Edmonds Development Services Department Planning Division Phone: 425.771.0220 Fax: 425.771.0221 .140. 1%911 The Critical Areas Checklist contained on this form is to be filled out by, any person preparing a Development Permit Application for the City of Edmonds prior to his/her submittal of the application to the City. The purpose of the Checklist is to enable City staff to determine whether any potential Critical Areas are, or may be, present on the subject property. 'Me infbrmation needed to complete the Checklist should be easily wvailable frow observations of the she or data available at City Hall (Critical areas inventories, maps, or soil surveys). Date Received: _?-c25 -0 City Receipt #: - Z aD 50 Critical Areas File 10 Critical Areas Checklist Fee:- sm.00 Date Mailed to Applicant A property owner, or his/her authorized representative, must fill out the checklis� sign and date it, and submit it to the City. The City will review the checklK make a precursory site visit, and make a determination of the subsequent steps necessary to complete a development permit application. Please submit a vicinity map, along with the signed copy of this form to assist City staff in finding and locating the specific piece of property described on this form. In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assistant staff in completing their preliminary assessment of the site. 'ne undersigned applicant, and his/herlits heirs, and assigns, in consideration on the processing of the application agrees 'to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action -or infraction based in whole or part upon false, misleading, inaccurate or incomplete information furnished by the applicant, his/her/its'ag'ents or employees. By my signature, I certify that the information and exhibits knowledge and that I am authorized to file prli)pplication pn, SIGNATURE OF APPLICAW/AGM Property,Ownees Authorization I B� my signature, I cer* that I have al/rnize� and grant my permission for the public officials purposes of inspection and p i dantto - �P�rl 7 SIGNATURE OF OWNER lewith submitted are true and correct to the best of my b�half of the owner as listed be o . '7 ca. DATE 3 rVQ �o the above Applicant/Agent to apply for the subject land use application, and the staff of the City of Edmonds to enter the subject property for the Owner/Applicant: AJA,& 14U 9 C4 C �'OCQJ ?4 cA- AV Name V 7 )�61 Street Address ig Af a,.,- I 0�' city State Zip TelephonCz/-75) 61 7- 2 3 1 Email address (optional): DATE, 3 - 100� Applicant Representativ : LOW,Li5 / ill -6,ove Name / &6Q7 / Street Address 1,61 O'cZ. CitV State Zip Telephone( 42S 74/ 3— Email Address (optional): Crifical Areas Checklistdoc/3.19.2001 Suite B - 16521 Highway 99 - Lynnwood, WA 98037-31 E Town & coggm* Everett: (425) 258-4171 Puyallup: (253) 840-9552 BUILDINGS Administrative Headquarters: (425) 743-1565 FAX: (425) 742-4378 Toll Free: 1-800-824-9552 Contractor's Lic. #: TOWNCPF099LT Quality. Our Future Depend; On It. <::) 0 .7 Tax Account A el Site Plan Please Check After Doing Site Plan: 0 Septic and drainfield _,,Q-tot size Draw North Arrow in Circle roperty dimensions _JE;-8ewer lines 0 Elevation of property ��xisting buildings 0 Setbacks of proposed & existing buildings 0 Bodies of water roposed building .4ErMain road with name 0 Floorplan 0 Easements 4�rAccess to proposed bui:ding 0 Slopes & Contours (5'increments) Job Name-.,I�l oIC Job Site Address: j Legal Description: Lo+ "eo,*. I,q; 14 C<) � RECEIVED eI e- d,,,ae� 'I z��o 6q4l MAY 2 2 2002 BUILDING DEPT 10 wAl, DO' c 09(AUe C 4 100 Lo4- ct o c?,c P Poq C ti 00CV_ (F'I-s4cm _f, I T 00 APPROVED AS NOTED O/By ENGINEERING t, 0 Lu' C- S' lZe ?— 1, 1 J P R op LLi 1 6 cu Ai (2 rg Date: !i(2_6+ o -L e Lk S P L) + QC1, J (A- C. D c,_4 u- v^ (P c) c e3 APPROVED BY PLANNING ADD GUTTERsOOWNSMM C 4- 160 .5 AND SPLASHBLOCKS ftv(q a� 4— 11130 CaVMCTOR IS REMS11 FOR XE ERO$ION PONII Ay2LROA C+' -Lb 0 - 's . T I GE �'N IM 7Er -76- Ck-/, i M V� VV\ 1-44,tT 4 15- P (Zo CA C (A Re ck ct l' o' L C'� +( A - ZONE SETBACKS: FRON, SIDE. OTHER — HEIGHT /5" A11-11i 61�— W I "REET FILE DO NOT SIGN INCOMPLETE SITE PLAN! Customer has verified and approved the Ic n�.4,r,r, of the building, orientation of the building to the North, and verifies that all White - Customer Copy White - Office Copy Yellow - Accounting Pink- Produc!: -1 utfliffes are shown art t'!z �rin�-.,;,,! ;n ) DATE RECEIVED CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAMEMAYE OF BUSINESS fga-/'o 1 ZuAwe MI.A e no c-A-- MAILING AVORESS ,Qz5 / C? — 9 P L— Vj CITY ZIP TELEPHONE I T 16jkvin�jds qF000 mas-) NAME IRR IC-tia cweeR iija ADDRESS CITY ZIP TELEPHONE Itz S-) 6 qq — S-7 o NAME I PERMIT EXPIRES USE PERMIT J#7 ZONE r,-j fdwe? NUMBEW4AX JOB ADDRESS",5—/ PLAT NAME/8UBDIVISION NO. I LOT NO. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING — PROPOSED REQUIRED DEDICATION— FT METERSIZE LINE SIZE I NO. OF FIXTURES SUITE/APT# LID NO. LID FEE $ TESCP Approved RW Permit Required Street Use Permit Req'd Inspection Required Sidewalk Required Underground wiring required PRV REQUIRED YES C3 N.)e REMARKS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE I WGFgMer Me— Rv;f b IrN -. rT'*i =[?e-%e-- ift t, I z z 0 z -T- W M e-1 C6 U-.Aj fp ENGINEERING REVIEWED/DATE ADDRESS .STE, f3 F . I I RE:.REVI EWEDBY DATE CL CITY /zip TELEPHONE STAJJ LICENSE NUMBER TowQ('Pr-'699 EXPIRATION DATE Y M—ANC&OR CU,,­,!,�� SHORELINE,OR ADB# INSPECTION REQ'D CI,YES&01— BOND POST ED z z SEPAAEWEw COMPLETE EXP SIGN AREA ALLOWED,j"PROPOSED" HEIGHT ALLOWED PROPOSED PROPERTY TAX ACCOUNT PARCEL NO. 00- c-qq - Q -0 ..3 o ca NEW RESIDEN . TIAL PLUMBING MECH ADDITION 0 COMMERCIAL 0 COMPLIANCE OR CHANGE OF USE REMODEL 0 APARTMENT El SIGN 0 REPAIR GRADING FENCE 50 CYDS 'X FT) LOT COVERAGE- ALLOWED PROPOSED '? '�' f . 1 to REQUIRED SETBA CKS (FT.) FRONT � SIDE -,',REAR 7 PROPOSED SETBACKS (FT) FRONT URSIDE REAR PARKING REQ 11DEb 'D PRO% LOT AREA I PL�NNINQ RtVIEM ED BY- �DATE 0 DEMOLISH 0 TANK OTHIER,' �GARAOG C3 R ETA I EN RIN ORT R CK Y��ALL�. 0 R (TYPE OF USE. BUSINESS OR ACTIVITY) EXP CHECKED BY TYPE OFCONSTRUCTiON.­ cot E OCCUPANT GROUP Z4 NUMBER OF STORIES NUMBER OF:. D WELLING UNITS CRITI CAVVrf f AREAS NUMBER SPECIAL INSPECTOR REQUIRED 0 YES AREA OCCUPANT LOAD DESCRIBE WORK TO BE DONE REMARKS PROGAESS INSPECTiONS-PEW U66i'dil/FINAL INSPECTION REO'D C T- 177riz-a. We' - q C, 612 VALUATION FEE ---------- PLAN CHECK FEE HE4T SOURCE GLAZING % LOT SLOPE % IV/ BUILDING 5-717 12 VESTED DATE PLAN CHECK NO,,: 'F -061�&4 THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO MECHANICAL t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE GRADING/FILL SEPARATE PERMISSION. E4 2 STATE SURCHARGE� /& 5� PERMIT APPUCATION: ISO DAYS - _ PERMIT ILIMIT- I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS E, ENG. REVIEW FE S 15(a) SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS ENO. INSPECTION FEE IN INTEREST, AGREES TO INDEMNIFY� DEFEND AND HOLD HARMLESS THE CITY OF LANDSCAP It' 2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND INSPECTION FEE ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE DE EMEDTO MODIFY, WAIVEOR REDUCEANY REQUIREMENT OF ANY CITY ORDINANCE RECE PLAN CHECK DEPOSIT _j 0 NOR LIMIT IN ANYWAYTHE CITY'SABILITYTO, ENFORCE ANYORDINANCE PROVISION.' X. TOTAL AMOUNT D R CEIPT/ UE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF APPLICATION APPROVAL THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED CALL This application Is not a permit until signed by the IN VIOLADON-W THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO Building Official or his/her Deputy: and Fees are paid. and FOR INSPECTION Is acknowledged in space provided. WORKI�I?N'S COIPENSATION INSURAfFE AND RCW 18.27. _receipt A SIGNA URE (0 ER 01(�A�6EI� DATE S19NED 0 Ff (425) M91 S SIGNATURE D 1�- y ";A 771-0220 ATTP1#10N EXT 333 R31 SED By UATE' IT IS O�XAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL (1-7Z 771-0221 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX ORIGINAL - FILE - YELLOW - INSPECTOR PINK OWNER 5/98 - - GOLD - ASSESSOR City 9f Edmonds Permit No: RIGHT-OF-WAYXONSTRUCTION PERMIT 'Issue Date: A. Address or Vicinity of (23N.iruction: c2251q J!n�k. a- We-S 77 B. Type of Work (be specific): DR l,LQ&WJ A P 0 G_-55 Af&dA 0 14 C. Contractor: 7a fAid 17;Q(AAb4*,e, Mailing Address: 1&t��l State License #: —116f4j& r_,� 0,?9/-r b. Building Permit # (if applicable): 00A — /3,Q Contact: 1.1 /'A/ A-1 Phone: wzs-) Liability Insurance: Bond: $ Side Sewer Permit # (if appli , cable E. r-1 Commercial F1 Subdivision F1 CityProject F EUC (PUD, VERIZON, PSE,'AT& T, OVWD) Multi -Family Single Family El Other — - , - —INSPECTOR: b- F. PAVEMENT CUT: [-I YES El NO G. SIZE OF CUT X CONCRETE CUT: El YES`­.1 [:]NO. Al'I'LICANT TO IMAI) ANI) SIGN INDEMNITY. Applicant understands by his/her signature to this application h,elshe holds the City of Edmonds harmless from injuries, damages or claims of any kind or description whatsoevO, foreseen* or unforeseen, that may be,made against the City of Edmonds or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and attorneyfees by reason ofgranting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOW!NG THE FINAL INSPECTION AND A CCEPTANCE OF THE WORK - ESTIMA TED RESTORA TION FEES 97LL BE HELD UNTIL THE FINAL STREET PA TCH is COMPLETED B Y CITY FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. 1* Traffic control and publie safety shall be in accordance with City regulations as required by. the City Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification verifying completion of the required.t , raining in their possession'. + Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City- ,1. approVed material prior to the end of the workday — NO EXCEPTIONS. # Three sets of construction drawings of proposed work are required.with the permit application. CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK I HA VE READ THE ABO VE TEMENTSAND UNDERSTAND THE PERMIT REQUIREMENTS AND.ACKNOWLEDGE THA T I MUST MAAE THE P COPY OF THE PERMITA VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS --Signature: Date: C_;�, (Contractor —or Agent) FOR CITYUSE ONLY Approved by: Right-of-wayFee:. Time Authorized: Void After e E_'� 9 la 4 PA' M M Disruption Fee/Fund Special Conditions: 00611 t7i Pa 1, d1r, ra 7Y97 Restoration Fee: -F" L, X')C� Total Fe e* Receipt No: JA00 "'A Issued by:. UPON COMPLETION OF IrgERMITTED WORKAN ENGINEERING-,�FI!NA�L."�-"�,i�l' "INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS COMMUNITY DEVELOPMENT CODE (Phone 425-771-0220, Ext. 1326) FINAL APPROVAL OFPERMITTED WORK., DATE: Inspector's Siinature For inspection requirements see Engineering Inspection Information handout. NO W01ZK SHALL BEGIN I'MOIZ TO I'EIMIT ISSUANCE DAMy Documents\Forms\Engnrng\ROWpermit dGc